NPI | 1780071118 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER KAY NEWELL Manager 765-364-4435 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 71002953A) |
Enumeration Date | 2015-04-23 |
Last Update Date | 2024-01-24 |